title: A biomechanical study of flexor tendon repair in zone II: comparing a combined grasping and locking core suture technique to its grasping and locking components.
abstract: BACKGROUND
  All previous experimental and clinical repairs of flexor tendons in zone II have used either a grasping or a locking technique. In this article, a combined (grasping and locking) repair was compared biomechanically to its grasping and locking components.
  
  
  METHODS
  Using fresh flexor profundus adult sheep tendons, three techniques of tendon repair were tested biomechanically: the 'three figure-of-eight sutures' (a six-strand grasping technique), the 'locked cruciate repair' (a four-strand locked technique) and the 'combined technique' (a 10-strand repair using both the figure-of-eight and cruciate sutures). All repairs were tested to single-cycle tensile failure using a computerised tensometer. For each repair, the 2-mm gap force and the ultimate breaking (failure) force were recorded.
  
  
  RESULTS
  Biomechanically, the combined repair was found to be the strongest regarding both gap and failure (P<0.025; two-tailed by the Mann-Whitney test).
  
  
  CONCLUSIONS
  The combined 10-strand repair is stronger biomechanically than its grasping and locking components.
authors.affiliation: Division of Plastic Surgery, King Saud University, Riyadh, Saudi Arabia. moqattan@hotmail.com
authors.forename: M M
authors.initials: MM
authors.lastname: Al-Qattan
authors.forename: M A
authors.initials: MA
authors.lastname: Al-Rakan
authors.forename: T S
authors.initials: TS
authors.lastname: Al-Hassan
mesh_terms: D000818:Animals; D001696:Biomechanical Phenomena; D008422:Materials Testing; D012756:Sheep; D018709:Statistics, Nonparametric; D013536:Suture Techniques; D013537:Sutures / Q000592:standards*; D013710:Tendons / Q000502:physiology / Q000601:surgery*; D013718:Tensile Strength / Q000502:physiology*